The present invention relates generally to an ultrasonic surgical device delivery system and particularly relates to apparatus and methods for facilitating attachment and detachment of an ultrasonically-actuated blade/coupler assembly and an acoustical mount therefor.
Ultrasonic surgical devices for performing a variety of surgical procedures are well known. Generally, these surgical devices are hand-held instruments connected to a source of ultrasonic energy. The ultrasonic energy is transmitted through a connection or mount between the ultrasonic energy source and a hand-held coupler which mounts the surgical tool, for example, a surgical blade mounted at the tip of the hand-held coupler. Ultrasonic energy is therefore transmitted through the coupler to the surgical blade to facilitate a precise surgical incision.
Ultrasonic surgical devices, however, are not without problems when used. For example, an acoustically-actuated surgical device should be used in a sterile field. Ready attachment and detachment of the surgical device relative to the ultrasonic energy source is highly desirable. Traditionally, a screw-type mechanism has been employed to secure the ultrasonic surgical device to its acoustical mount so that the ultrasonic energy may be transmitted through the mount to the surgical device Because of the need for a sterile environment, the surgical device must be readily attached to the acoustical mount for use in a manner which maintains the sterile field. Quick detachment of the surgical device from its acoustical mount after use for sterilization or disposal is also highly desirable.
It will be appreciated that the connection between the surgical device and the ultrasonic energy source requires a tight union so that ultrasonic energy may be efficiently transmitted to the device at the desired power levels When a screwthread is used, the surgical device is often over-tightened to the acoustical mount by the surgeon, nurse or technician in order to ensure that ultrasonic energy is properly transmitted to the surgical device. Typically, this causes difficulties, not only when attaching the surgical device and its mount, but also when detaching the surgical device from the mount after use, i.e., it is often overtightened and therefore difficult to detach. Also, when attaching and detaching the surgical device and the acoustical mount, there is the obvious danger of injury to the doctor, nurse or technician as a result of contact with the surgical device itself, e.g., the blade. Additionally, it is very difficult for surgeons, nurses or technicians to connect and disconnect the surgical device and its acoustical mount in a sterile field using typical fastening devices such as pliers, wrenches and the like and without causing injury.
According to the present invention, there is provided an ultrasonic surgical device delivery system that overcomes the foregoing and other problems associated with the attachment and detachment of an ultrasonic surgical device and its acoustical mount and provides apparatus and methods facilitating attachment and detachment of an ultrasonic surgical device and an acoustical mount therefor affording various advantages in construction, operation and use in comparison with traditional prior systems. Particularly, the present invention, in a preferred embodiment thereof, provides an adaptor having a generally cylindrical sleeve and a radial flange at one end, the flange having a conical surface for directing the surgical device into the sleeve. The surgical device may, for example, include a blade/coupler having a surgical blade at one end and an internally threaded female connection at its opposite end for connection to the acoustical mount. Flats are provided along both the coupler of the surgical device and the interior of the adaptor sleeve whereby, when the adaptor receives the blade/coupler, the adaptor and coupler may be rotated as a unit. Preferably, the rearwardly facing annular surface of the flange is provided with a plurality of cam surfaces which form part of a circular ratchet mechanism. The cam surfaces may, for example, comprise ramps in each quadrant of the rearwardly facing annular surface and which ramps terminate in end stops.
A cooperating cylindrical member having a radially extending end flange is received over the sleeve of the adaptor and is rotatable relative to the adaptor. The end flange of the cylindrical member preferably has a pair of cam followers, e.g., end projections, for engaging two of the cam surfaces along the rearwardly facing annular surface of the adaptor flange, the projections being provided at diametrically opposed locations. Additionally, the cylindrical member is provided with diametrically opposed, radially extending wings preferably extending from the end flange the full length of the member, such wings facilitating manual purchase of the member and its rotation relative to the adaptor. The wings are preferably circumferentially spaced 90.degree. from the end projections. In this manner, the portions of the end flanges of the cylindrical member carrying the projections may resiliently flex in an axial rearward direction. The cylindrical member is received about the adaptor sleeve and secured against axial movement relative thereto by spring-biased fingers at the end of the adaptor sleeve remote from the adaptor flange.
Preferably, the blade/coupler, adaptor and cylindrical member are provided in a sterile package, in assembly or not, as desired. In use, the blade/coupler, adaptor and member are removed from their sterile packaging and, if not assembled, are assembled one to the other and to the blade/coupler. Particularly, the blade end of the blade/coupler surgical device is inserted into the adaptor sleeve, the conical end surface of the adaptor facilitating that insertion by guiding the blade into the sleeve. The blade/coupler is also rotationally aligned with the adaptor sleeve such that the flats on the coupler engage the flats within the bore of the sleeve. The interior edges of the conical surface engages stops carried by the blade/coupler limiting its axial movement into the adaptor. It will be appreciated that the blade is wholly received within the adaptor sleeve. Thus, the sleeve protects an individual against exposure to the blade during attachment or detachment of the device relative to the acoustical mount.
To attach the surgical device to the mount, the blade/coupler is threaded on the mount. When the coupler is loosely tightened to the mount, the wings on the cylindrical member are grasped and the member is rotated in the conventional screw-threading direction. The end projections on the member frictionally engage the cam surfaces, and consequently, the adaptor and member are rotatable as a unit to further tighten the blade/coupler to the acoustical mount. As the joint tightens and the resistance to further threading increases, the projections start to slide along the cam surfaces while continuing to apply torque to the adaptor and the coupler whereby the coupler is further tightened. Particularly, the end projections move up the ramps, causing the flange carrying the projections to resiliently flex or yield in an axial rearward direction and hence cause greater frictional engagement between the end projections and the cam surfaces. At a predetermined torque, the projections will move past the high points or trailing ends of the cam surfaces and spring back to engage the leading portions of the next cam surfaces. Thus, upon rotating the member further, a ratcheting action is provided at a predetermined torque value between the cylindrical member and the adaptor. In this manner, the individual attaching the blade/coupler to the acoustical mount will recognize that sufficient torque has been applied to the blade/coupler to ensure its connection with the acoustical mount in such manner that the ultrasonic energy will be efficiently transferred to the surgical device and this will be accomplished without over-tightening the connection. The adaptor and member are then removed from the blade/coupler assembly and the ultrasonic surgical device is ready for use.
To detach the surgical device from the acoustical mount after use, the adaptor and member are applied to the blade end of the device similarly as previously described. The cylindrical member, however, is rotated in the opposite direction, i.e., in a direction to unthread the blade/coupler from the acoustical mount. The projections on the member will thus engage the end stops of the cam surfaces and rotate the adaptor and coupler to provide the necessary unthreading action. Essentially unlimited torque may be applied to the member when rotated in the unthreading direction. Importantly, the unthreading action is provided with the blade completely encapsulated within the sleeve of the adaptor, thus protecting the individual removing the surgical device from its mount from cuts and puncture wounds. Once removed, the entire blade/coupler, adaptor and cylindrical member assembly may be thrown away. Alternatively, the adaptor and member sub-assembly may be removed from the blade/coupler, whereby the latter may be sterilized for reuse.
With the foregoing features in mind, it will be readily seen that there are significant advantages and benefits afforded by the system of the present invention. For example, the surgical blade during attachment and detachment from the acoustical mount is completely encapsulated within the sleeve of the adaptor, thereby preventing injury to the individual performing those tasks. Additionally, the blade/coupler, together with the attaching and detaching mechanism, may be provided is part of a sterile package for single use and disposal. Further, the ratcheting action during attachment ensures that sufficient torque has been applied to the coupler so that the requisite ultrasonic energy will be efficiently transmitted from the ultrasonic source to the surgical device. Further tightening beyond the predetermined torque is thus not necessary and the problems associated with over-tightening are completely eliminated. The ratchet mechanism also signals the individual attaching the device to the mount that sufficient tightness has been achieved whereby over-tightening and difficult removal is prevented. Additionally, during removal, the same delivery system is used. The one-way ratchet also enables virtually unlimited torque to be applied to the coupler in the reverse unthreading direction to facilitate its removal from the acoustical mount. Further, when removed, the adaptor and member may remain attached to the blade/coupler throughout its disposal to provide a protective enclosure for the blade, thereby avoiding accidents resulting from the sharp edge of the blade and transmission of infectious diseases.
Accordingly, and in accordance with a preferred embodiment of the present invention, there is provided apparatus for attaching a surgical device to a mount wherein the surgical device includes a coupler carrying a surgical tool and wherein the apparatus comprises an adaptor including a sleeve for receiving the surgical tool, means carried by the adaptor and engageable with the coupler when the surgical tool is received by the adaptor for rotating the coupler upon rotation of the adaptor and means carried by the adaptor for rotating the adaptor to rotate the coupler. Also provided are means cooperable between the rotating means and the adaptor for limiting the torque applied by the adaptor to the coupler when the surgical tool is being attached to the mount.
In a further preferred embodiment according to the present invention, there is provided a method for attaching a surgical device to a mount wherein the surgical device includes a coupler carrying the surgical tool comprising the steps of providing an adaptor having a sleeve containing the surgical tool and engageable with the coupler such that the coupler may be rotated upon rotation of the adaptor, providing a rotatable member carried by the adaptor, rotating the member to rotate the adaptor and coupler, and limiting the torque applied by the adaptor to the coupler in response to rotation of the member in one direction.
Accordingly, it is a primary object of the present invention to provide novel and improved apparatus and methods for attaching and detaching a surgical device relative to its energy source.
These and further objects and advantages of the present invention will become more apparent upon reference to the following specification, appended claims and drawings.